Discussion of public health and health care policy, from a public health perspective. The U.S. spends more on medical services than any other country, but we get less for it. Major reasons include lack of universal access, unequal treatment, and underinvestment in public health and social welfare. We will critically examine the economics, politics and sociology of health and illness in the U.S. and the world.

Monday, September 05, 2011

Player Piano

For those who haven't read it (could there be such people?) Player Piano is a novel by Kurt Vonnegut Jr. It portrays a dystopian future in which automation has displaced most workers, leaving the world divided between a small technocratic class and the redundant masses. I join quite a few bloggers in recommending this essay by Harold Myerson, who summarizes our predicament:

Today, the economy that arose on manufacturing’s ashes has turned to ashes itself. The Wall Street-Wal-Mart economy of the past several decades off-shored millions of factory jobs, which it offset by creating low-paying jobs in the service and retail sectors; extending credit to consumers so they could keep consuming despite their stagnating incomes; and fueling, until it collapsed, a boom in construction.

We are only now beginning to understand the toll this economy has taken on America’s workers — and on our working men in particular. A stunning study from Michael Greenstone and Adam Looney of the Hamilton Project, published in the Milken Institute Review, reveals that the median earnings of men ages 25 to 64 declined 28 percent between 1969 and 2009. Within this age group, the median earnings of men who completed high school but didn’t go on to college fell 47 percent, while the median earnings of male college graduates also declined, if only 12 percent.

Myerson also points out that the proportion of adult men who are employed at all has also fallen sharply. He doesn't note that women's labor force participation increased over this period, which is the only reason families managed to nearly hold their own -- until recently. The employment to population ratio has now fallen sharply. New jobs are never going to come from the capitalists because they are concerned only with profit, and they have been pursuing profit by replacing workers with machines and chasing the cheapest possible labor around the globe.

Many people claim that in the long run, jobs will come because somebody has to build the machines, but that is fallacious. For a machine to be cheaper than a worker the labor embodied in its construction must be far less than the labor it replaces. In order for a share of rising productivity to go to workers, there must be a shortage of workers, and that we do not have. As long as we have a vast reserve army of the unemployed, capital can claim all the gains. Does this remind you of any particular thinker of the past?